"As we move into October, many school children are being diagnosed with attention deficit hyperactive disorder (ADHD). For a good definition of ADHD, see the WebMD article.

Often such students cannot remain seated at their desks, stay focused on the class assignment, finish their seat work, or have other behavioral or impulsive actions. The question then arises, does my child need to go on medication for ADHD? Some will tell you yes; others say no.

1. Amphetamines like Adderall and Vyvanse are addictive and may cause insomnia, high blood pressure, irregular heartbeat, and/or seizures.2. Concerta, Ritalin, Metadate, Daytrana, and Quillivant (methlphenidates) may cause insomnia, aggression, mood swings, behavior changes, twitching, and even shaking.3. Many argue that such drugs carry too high a risk for children. As Kelly Patricia O’Meara with the CCHR, a Mental Health Watchdog agency, states: “there is not now, nor has there ever been, any medical or scientific test to show that any child diagnosed “ADHD” is suffering from a medical condition requiring drugs to ‘treat’ it.”

O’Meara goes on to quote the Department of Pediatrics at Harvard Medical School in connection with Boston Children’s Hospital, who concluded from their research that the clinical trials for drugs presently approved for ADHD have not been tested for long-term effects or safety. O’Meara continues by citing the research report:

“Literally millions of children have been prescribed ADHD drug ‘treatments’ with virtually little to no understanding of the long-term safety or efficacy of the drugs. According to the information given in the study, two thirds of the 6.4 million American children (including 10,000 toddlers) diagnosed with the alleged ADHD are nothing short of a fraudulent life-threatening drug experiment.”

O’Meara also explains that the Food and Drug Administration (FDA) has identified “more than 17,000 adverse reactions connected to ADHD drugs.” Some of these drug effects can include abnormal heart rate or rhythm, depression, hallucinations, insomnia or trouble sleeping, anger and violence, seizures, stunted growth, stroke, and, in rare cases, even death.

So, why do we medicate children, even toddlers, for ADHD?

I have tried to compile a list of websites for parents and teachers to refer to in answering this question. I intentionally avoided any sites supported by pharmaceutical companies. I want parents to evaluate the decision without the economic incentive put forth through research supported by pharmaceutical companies. In other words, if your research is supported by a drug company, it’s biased. Let’s face it, pharmaceutical companies do not support research that does not show a positive result for medicating students, but there are alternatives.

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder diagnosed for children, and ADHD meds are a billion-plus big-money industry, some estimates say as much as $13 billion a year. This was reported in the news:

“Last year, Shire Pharmaceuticals, which makes Adderall, settled with the Department of Justice for more than $50 million based, in part, on allegations that it marketed its ADHD based on unsupported claims that it would prevent, say, poor academic performance.”

There is absolutely no research that supports that placing children on ADHD medication will help them learn, read, or perform better in the classroom. If someone tells you that, then request to see the research. Then check to make sure that the research was not paid for by a pharmaceutical company. One book that gives the most comprehensive discussion of meds and ADHD is by Stephen Hinshaw and Richard Scheffler (2014):The ADHD Explosion: Myths, Medication, Money, and Today’s Push for Performance. Check your library.

“There are at least three very good reasons for not jumping straight to medications.

1) "The research evidence so far supports only the fact that stimulant medications (the mainstay of ADHD treatment) work well over the short term, about 70% of the time. The long-term research we have so far — and there is very little of it — fails to show long-term benefit. In fact, the largest long term study showed that the benefits of medication noted after one year disappear by a three-year follow-up.

2) "There are significant side effects in many children. Some are clear physical and psychological effects like hallucinations, tics, and weight loss. There are also more subtle effects, like low-grade depression or a ‘loss of joy.’ I have had many parents tell me the medication was working but he or she ‘just wasn't my child.’

3) "We don't know what the long-term effects of stimulant medication are on the developing brain. When psychotropic medications, which have significant effects on neurotransmitter balance, are given to a developing brain, there is going to be an effect on how that brain develops. Although we know that there do not seem to be dramatic long-term effects, like kidney or liver damage or psychosis, there is really no research on subtler effects…. The next logical question is whether there are effective non-pharmaceutical interventions for ADHD? The answer is an unequivocal yes.”

Since there are alternatives, as Dr. Sanford states, let’s explore some of those alternatives.

1. Children diagnosed with ADHD need programs that emphasize step-by-step procedures and active hands-on learning.2. Classroom interventions should stress intrinsic motivation (no reward or incentive programs).3. Programs with a social skills component (interaction with others) are typically more successful, while programs consisting mostly of homework help and recreational activities do not improve student grades or ADHD behavior. 4. Working alone does not teach children how to control their ADHD behavior. They learn best in a group setting.5. Children diagnosed with ADHD must learn self-management skills in a group setting in order for such retraining to be effective and transfer back to the classroom.

I conducted a 2009-2010 study with students from the schools who had been diagnosed with ADHD. Some were on meds, some were not, but the children on ADHD medication sent to my reading clinic were sent because they were failing in reading and uncontrollable in the classroom. The medication was not working. Before I could teach the students to read, I had to teach them how to work together and follow classroom instructions. For example, the children painted a puppet stage. This was a group activity at my reading clinic, and I carefully controlled the painting session. A piece of cloth was spread out on top of the table. Everyone sat around the table in a circle and was given the opportunity to paint one at a time with washable tempera paint. The desired behavior was to wait for your turn. I didn’t care about their painting skills. I wanted cooperative behavior. I did not use reprimands, punishments, or rewards. I stressed only intrinsic motivation: no prizes, no rewards, only praise when a child took a turn correctly. If children weren’t in their seats or quietly waiting for their turn, the game rule was to skip and go to the next person. We always came back around the circle, and even fidgety students soon learned to sit quietly for their turn. Each child was given an assignment: six blades of grass, three trees, or a specific flower. There was no competition. Simple painting skills were demonstrated as needed, but the object was not the painting. Yet, the children were very excited about the puppet stage they created. I ended the session with a free painting time by giving each of the children a piece of paper and the opportunity to paint whatever they would like. The only rule during the free painting time was to share paint and space on the table, while working together. This exercise was so successful that I have repeated it with many groups. It can be used with one individual student or with a group of students—any age. For more information about this activity, see my book Group-Centered Prevention Programs for At-Risk Students (2011).

Another suggestion is listed in the Prevention Corner column of The Group Psychologist newsletter and speaks directly for teachers, community workers, or parents working with children in a group setting. Read the column on page 20 of the newsletter for suggestions.

Don’t simply turn to meds because it’s the easiest option. Consider the damage drugs can do. Explore behavioral options. After-school programs that emphasize group interaction as we do at my reading clinic are perfect for students diagnosed with ADHD behaviors.​

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Elaine Clanton Harpine, Ph.D.

Elaine is a program designer with many years of experience helping at-risk children learn to read. She earned a Ph.D. in Educational Psychology (Counseling) from the Univ. of Illinois at Urbana-Champaign.